To the Editor: Dr Krasuski and colleagues1 investigated the association of intraoperative patent foramen ovale (PFO) closure with perioperative outcomes and long-term survival. The study found that the risk of perioperative stroke was not associated with closure of a PFO at the time of incidental intraoperative discovery. Technical advancement and the widespread use of intraoperative transesophageal echocardiography (TEE) have increased the incidence of diagnosing a PFO at the time of surgery and have raised questions about best possible management.2,3
Mirakaj V, Thix CA, Rosenberger P. Intraoperative Diagnosis and Management of Patent Foramen Ovale. JAMA. 2009;302(21):2317–2318. doi:10.1001/jama.2009.1743
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